Abstract
During the 13 months between June 1985 & June 1986 we immunized 87, 541 children ages 2-5 yrs of age with b-CAPSA 1 vaccine. We have conducted extensive surveillance for cases of invasive disease due to Hib in vaccinated and unvaccinated cohorts using multiple modality surveillance techniques:active and retrospective review of microbiology records, an active and retrospective review of pediatric ward records, a computerized review of all hospitalized patients for diagnoses possibly compatible with Hib disease and a review of all patients hospitalized outside our HMO. We have seen two cases of vaccine failure and 21 cases of culture positive disease in unvaccinated children. We calculate 3.49 cases per 100,000 patient years of observation in the vaccinated group and 25.61 cases per 100,000 patient years in the unvaccinated cohort. Efficacy is thus estimated to be 86.4% for b-CAPSA 1. Studies are ongoing at this time.
In addition we have seen 4 cases of disease due to Hib within one week of vaccination. This is a 10 fold increased rate over the backround risk of disease in unvaccinated children (p 1ess than 0.001 by Fischer exact test). This may be due to a real increase in disease risk following vaccine or may be due to self selection of patients seeking vaccine after exposure to an index case. The possible factors operative in these four cases is currently under investigation.
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Black, S., Shinefield, H. EFFICACY OF HAEMOPHILUS INFLUENZA TYPE B (b-CAPSA 1) POLYSACCHARIDE VACCINE IN 87,541 CHILDREN. Pediatr Res 21 (Suppl 4), 322 (1987). https://doi.org/10.1203/00006450-198704010-00928
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DOI: https://doi.org/10.1203/00006450-198704010-00928